The following article features coverage from the American Society of Clinical Oncology 2020 meeting.
Significantly higher levels of pain were reported by women with a history of ovarian cancer who were classified as having a late chronotype compared with an early or mid-chronotype (P <.05). These baseline findings from an ongoing randomized trial evaluating lifestyle interventions were presented during the ASCO20 Virtual Scientific Program.
Few studies have evaluated the effect of chronotype, a manifestation of underlying circadian rhythm, on quality of life and other lifestyle outcomes in women with ovarian cancer.
This analysis assessed the association between chronotype and self-reported pain, sleep duration and quality, diet quality, physical activity, and the levels of systemic metabolic biomarkers at baseline in 438 patients with previously treated stage II, III, or IV ovarian, fallopian tube, or primary peritoneal cancer enrolled in the large, randomized, phase 3 Lifestyle Intervention for ovarian cancer Enhanced Survival (LIVES) study (ClinicalTrials.gov Identifier: NCT00719303). All patients had completed ovarian cancer treatment at least 6.5 months prior to enrollment.
Chronotype was defined in this study according to patient-reported bedtime as assessed using the Pittsburg Sleep Quality Index, with early, mid-, and late chronotypes corresponding to self-reported bedtimes of prior to 9 pm, between 9 pm and 12 am, and after 12 am, respectively. Patient-reported outcomes regarding health-related quality of life (HRQoL), including pain, were evaluated using the Rand-36 questionnaire, other validated measures were used to assess diet and physical activity, and levels of circulating biomarkers were evaluated at routine clinic visits.
Of the 438 patients included in the analysis, chronotype was classified as early, mid, and late for 33, 351, and 54 patients, respectively. While chronotype was not found to be associated with age, smoking history, and ethnicity, individuals with early chronotype had the lowest mean body mass index (22.9 kg/m2), followed by those in the mid-chronotype (27.6 kg/m2), and late chronotype (29.6 kg/m2) categories.
Other key study findings included significantly lower mean levels of sleep duration in those with late chronotype (7.4 hours) compared with mid- (10.3 hours) and early 8.6 hours) chronotypes (P <.05), although reported sleep efficacy was significantly higher in those with late chronotype compared with early and mid-chronotype (P <.05). Nevertheless, global sleep scores for those in all 3 categories of chronotypes were suggestive of disrupted sleep.
Regarding measures of HRQoL, only pain was significantly associated with chronotype, with higher levels of pain reported by individuals with a late chronotype compared with the other 2 groups (P <.05). Furthermore, significant associations between higher reported pain level and higher levels of C-reactive protein (P <.001) and fasting blood insulin (P =.015) were found that were independent of chronotype.
In her concluding comments, Tracy E. Crane, PhD, RDN, of the College of Nursing at the University of Arizona Cancer Center in Tucson, who was the lead author and study presenter, stated that plans were in place to perform longitudinal analyses of these measures according to LIVES study treatment arm assignment, and to include assessments of the circadian rhythms of study participants using actigraphy.